Medicare - CCW Condition Period Prevalence, 2015

Description: The conditions with the highest period prevalence rates are hypertension (58%) and hyperlipidemia (47%). Nearly one-third of the population has been treated for rheumatoid/osteo-arthritis (32%), ischemic heart disease (28%), and/or diabetes (28%).

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. Chronic conditions have a 1 to 3 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Only females are included in the denominator for endometrial and female breast cancer; only males are included for prostate cancer and benign prostatic hyperplasia. Beneficiaries may be counted in more than one chronic condition category.

Cardiovascular Conditions - Trends, 2006 - 2015

Description: The rates for several of the cardiovascular conditions have been fairly stable over time, with a slight decrease in ischemic heart disease (from 32.4% in 2006 to 28.2% in 2015) and heart failure (HF; 17.6% in 2006 and 14.5% in 2015). Atrial fibrillation has increased slightly, from 7.7% in 2006 to 8.6% in 2015.

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. Chronic conditions have a 1 to 2 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Cancer - Trends, 2006 - 2015

Description: The rate for female breast cancer has risen slowly over time – from 4.6% in 2006 to 5.6% in 2015. The rate for prostate cancer has decreased somewhat – from a high of 7.51% in 2011 to 7.0% in 2015. The rates of lung, colorectal, and endometrial cancer were stable over time.

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. These conditions have a 1 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Only females are included in the denominator for endometrial and female breast cancer; only males are included for prostate cancer. Beneficiaries may be counted in more than one chronic condition category.

Endocrine and Renal Conditions - Trends, 2006 - 2015

Description: There has been a large increase over time for each of the endocrine and renal conditions. The proportion of the population being treated for diabetes increased from 25.2% in 2006 to 28.2% in 2015. The period prevalence rate of chronic kidney disease has risen from 10.6% in 2006 to 19.3% in 2015. Acquired hypothyroidism increased from 11.2% in 2006 to 15.6% in 2015.

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. These conditions have a 1 to 2 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Cognitive and Mental Health Conditions - Trends, 2006 - 2015

Description: The rate of treatment for depression has increased over time – from 12.0% in 2006 to 17.7% in 2015. The prevalence of treatment for Alzheimer's disease or related senile dementia has been fairly stable over time; however, the proportion of treatment for Alzheimer's disease or related senile dementia that is comprised of Alzheimer's disease was 47.7% in 2006 and began to decline after 2010. By 2015, Alzheimer's disease comprised 39.9% of the Alzheimer's disease or related senile dementia prevalence.

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. Chronic conditions have a 1 to 3 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Musculoskeletal and Joint Conditions - Trends, 2006 - 2015

Description: The rates of hip fractures and treatment for osteoporosis have been stable over time. The rate of treatment for rheumatoid or osteoarthritis has increased from 26.9% to 32.1% (2006 to 2015, respectively).

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. These conditions have a 1 to 2 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Pulmonary Conditions - Trends, 2006 - 2015

Description: The period prevalence for asthma has increased over time - from 4.3% in 2006 to 5.3% in 2014 – and then up to 8.7% in 2015 (note that in 2015, ICD-10 coding of diagnoses began). Prevalence of treatment for chronic obstructive pulmonary disease (COPD) has been fairly stable - from 11.7% to 12.0% (2006 through 2015).

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. Chronic conditions have a 1 to 3 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Opthalmic Conditions - Trends, 2006 - 2015

Description: The proportion of Medicare beneficiaries with a cataract procedure began to decrease after 2006. The rate of cataract procedures went from 22.2% (in 2006) to 18.2% in 2015. Treatment for glaucoma has been fairly stable over time.

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. These conditions have a 1 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Other Conditions - Trends, 2006 - 2015

Description: The period prevalence of hypertension and hyperlipidemia has increased dramatically over time. In 2006, 54.3% of beneficiaries were being treated for hypertension compared to 58.3% in 2015. For hyperlipidemia treatment the increase was also significant –39.7% in 2006 to 47.3% in 2015. Anemia increased gradually over time – from 22.0% in 2006 to 24.9% in 2011, and then decreased to 22.9% in 2015. Benign prostatic hyperplasia has increased over time – from 11.4% in 2006 to 15.5% in 2015.

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. These conditions have a 1 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Medicare - Selected Chronic Conditions by Age Group, 2015

Description: The age distribution of Medicare beneficiaries with selected chronic conditions is shown. Some conditions are comprised largely of older Medicare beneficiaries (e.g., Alzheimer's and related senile dementia– where 78.8% of people receiving treatment are 75 years of age or older), and others are comprised largely of younger beneficiaries. For example, 62.7% of beneficiaries treated for depression are 74 years of age or less, as are 56.5% of people with diabetes and 51.5% of people with chronic obstructive pulmonary disease (COPD).

Technical Notes: Age is determined at the end of the calendar year. Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. These conditions have a 1 to 3 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Medicare - Selected Chronic Conditions by Racial Group, 2015

Description: The racial distribution of Medicare fee-for-service (FFS) beneficiaries with chronic conditions is shown. There is racial variation in the prevalence of treatment for these conditions. Although the white racial group comprises 80.4% of the Medicare FFS population in 2015, they comprise 87.1% of the subpopulation with chronic obstructive pulmonary disease, 86.3% of the population with depression, and 85.6% of the population with colorectal cancer. In 2015, the black racial group had disproportionately high rates of diabetes – 38.4% compared to 21.4% of white beneficiaries; also disproportionately high chronic kidney disease – 20.8% compared to 11.0%, heart failure -11.9% compared to 6.4%, and stroke – 3.6% compared to 1.9% of the white racial group.

Technical Notes: American Indian, Native American, Other, and Unknown races are grouped together due to small cell sizes. Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. These conditions have a 1 to 3 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Medicare - Selected Chronic Conditions by Sex, 2015

Description: The gender distribution of Medicare beneficiaries varies by condition. Overall, in 2015 Medicare fee-for-service (FFS), 54.4% of the population was female. For depression and Alzheimer's and related senile dementia, 67.4 and 63.5% of the subpopulation, respectively, was female. For chronic kidney disease (CKD), we have a higher proportion of males treated than we would have expected based on the overall population distribution of males - 48.5% with CKD were male vs. 45.6% of total Medicare FFS male.

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. These conditions have a 1 to 3 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Medicare - Selected Chronic Conditions by Medicare Status Code, 2015

Description: The reason for Medicare entitlement varies by condition. In Medicare fee-for-service (FFS) overall, 16.0% of the population were entitled to Medicare due to disability rather than age in 2015. A higher than expected proportion of people with treatment for depression were disabled 29.8%. For some conditions, a much higher proportion of the subpopulation were aged – for example, Alzheimer's and related senile dementia and colorectal cancer, with 94.4% and 92.1% of the subpopulations, respectively, entitled due to age.

Technical Notes: Classification used the Medicare status code, and combined ESRD and Disabled categories into the "Disabled" grouping. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who received treatment for the condition within the condition-specified look back period. These conditions have a 1 to 3 year look-back time period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage). Beneficiaries may be counted in more than one chronic condition category.

Diabetes Period Prevalence, 2015

Description: The number of Medicare fee-for-service (FFS) enrollees with diabetes varied by state. Colorado had the lowest rate (19.09%) and New Jersey had the highest (33.46%).

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full FFS coverage during the year who received treatment for diabetes within the 2-year look back period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage).

Alzheimer's/Dementia Period Prevalence, 2015

Description: The number of Medicare fee-for-service (FFS) enrollees with Alzheimer's disease or related senile dementia varied by state. Wyoming had the lowest rate (7.68%) and Washington, D.C. had the highest (13.94%).

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full FFS coverage during the year who received treatment for Alzheimer's disease or related senile dementia within the 3-year look back period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage).

Depression Period Prevalence, 2015

Description: The number of Medicare fee-for-service (FFS) enrollees with depression varied by state. Hawaii had the lowest rate (8.3%) and Rhode Island had the highest (23.56%).

Technical Notes: Period prevalence is calculated for these rates. Beneficiaries with full or nearly full FFS coverage during the year who received treatment for depression within the 1-year look back period. Please refer to the CCW Chronic Condition Categories for algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2015 and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of HMO coverage).